Incident type 2 diabetes attributable to suboptimal diet in 184 countries
Authors: Meghan O’Hearn, Laura Lara-Castor, Frederick Cudhea, Victoria Miller, Julia Reedy, Peilin Shi, Jianyi Zhang, John B. Wong, Christina D. Economos, Renata Micha, Dariush Mozaffarian, Murat Bas, Jemal Haidar Ali, Suhad Abumweis, Anand Krishnan, Puneet Misra, Nahla Chawkat Hwalla, Chandrashekar Janakiram, Nur Indrawaty Liputo, Abdulrahman Musaiger, Farhad Pourfarzi, Iftikhar Alam, Karin DeRidder, Celine Termote, Anjum Memon, Aida Turrini, Elisabetta Lupotto, Raffaela Piccinelli, Stefania Sette, Karim Anzid, Marieke Vossenaar, Paramita Mazumdar, Ingrid Rached, Alicia Rovirosa, María Elisa Zapata, Tamene Taye Asayehu, Francis Oduor, Julia Boedecker, Lilian Aluso, Johana Ortiz-Ulloa, J. V. Meenakshi, Michelle Castro, Giuseppe Grosso, Anna Waskiewicz, Umber S. Khan, Anastasia Thanopoulou, Reza Malekzadeh, Neville Calleja, Marga Ocke, Zohreh Etemad, Mohannad Al Nsour, Lydiah M. Waswa, Eha Nurk, Joanne Arsenault, Patricio Lopez-Jaramillo, Abla Mehio Sibai, Albertino Damasceno, Carukshi Arambepola, Carla Lopes, Milton Severo, Nuno Lunet, Duarte Torres, Heli Tapanainen, Jaana Lindstrom, Suvi Virtanen, Cristina Palacios, Eva Roos, Imelda Angeles Agdeppa, Josie Desnacido, Mario Capanzana, Anoop Misra, Ilse Khouw, Swee Ai Ng, Edna Gamboa Delgado, Mauricio Caballero, Johanna Otero, Hae-Jeung Lee, Eda Koksal, Idris Guessous, Carl Lachat, Stefaan De Henauw, Ali Reza Rahbar, Alison Tedstone, Androniki Naska, Angie Mathee, Annie Ling, Bemnet Tedla, Beth Hopping, Brahmam Ginnela, Catherine Leclercq, Charmaine Duante, Christian Haerpfer, Christine Hotz, Christos Pitsavos, Colin Rehm, Coline van Oosterhout, Corazon Cerdena, Debbie Bradshaw, Dimitrios Trichopoulos, Dorothy Gauci, Dulitha Fernando, Elzbieta Sygnowska, Erkki Vartiainen, Farshad Farzadfar, Gabor Zajkas, Gillian Swan, Guansheng Ma, Gulden Pekcan, Hajah Masni Ibrahim, Harri Sinkko, Helene Enghardt Barbieri, Isabelle Sioen, Jannicke Myhre, Jean-Michel Gaspoz, Jillian Odenkirk, Kanitta Bundhamcharoen, Keiu Nelis, Khairul Zarina, Lajos Biro, Lars Johansson, Laufey Steingrimsdottir, Leanne Riley, Mabel Yap, Manami Inoue, Maria Szabo, Marja-Leena Ovaskainen, Meei-Shyuan Lee, Mei Fen Chan, Melanie Cowan, Mirnalini Kandiah, Ola Kally, Olof Jonsdottir, Pam Palmer, Peter Vollenweider, Philippos Orfanos, Renzo Asciak, Robert Templeton, Rokiah Don, Roseyati Yaakub, Rusidah Selamat, Safiah Yusof, Sameer Al-Zenki, Shu-Yi Hung, Sigrid Beer-Borst, Suh Wu, Widjaja Lukito, Wilbur Hadden, Wulf Becker, Xia Cao, Yi Ma, Yuen Lai, Zaiton Hjdaud, Jennifer Ali, Ron Gravel, Tina Tao, Jacob Lennert Veerman, Shashi Chiplonkar, Mustafa Arici, Le Tran Ngoan, Demosthenes Panagiotakos, Yanping Li, Antonia Trichopoulou, Noel Barengo, Anuradha Khadilkar, Veena Ekbote, Noushin Mohammadifard, Irina Kovalskys, Avula Laxmaiah, Harikumar Rachakulla, Hemalatha Rajkumar, Indrapal Meshram, Laxmaiah Avula, Nimmathota Arlappa, Rajkumar Hemalatha, Licia lacoviello, Marialaura Bonaccio, Simona Costanzo, Yves Martin-Prevel, Katia Castetbon, Nattinee Jitnarin, Yao-Te Hsieh, Sonia Olivares, Gabriela Tejeda, Aida Hadziomeragic, Amanda de Moura Souza, Wen-Harn Pan, Inge Huybrechts, Alan de Brauw, Mourad Moursi, Maryam Maghroun, Augustin Nawidimbasba Zeba, Nizal Sarrafzadegan, Lital Keinan-Boker, Rebecca Goldsmith, Tal Shimony, Irmgard Jordan, Shivanand C. Mastiholi, Moses Mwangi, Yeri Kombe, Zipporah Bukania, Eman Alissa, Nasser Al-Daghri, Shaun Sabico, Martin Gulliford, Tshilenge S. Diba, Kyungwon Oh, Sanghui Kweon, Sihyun Park, Yoonsu Cho, Suad Al-Hooti, Chanthaly Luangphaxay, Daovieng Douangvichit, Latsamy Siengsounthone, Pedro Marques-Vidal, Constance Rybak, Amy Luke, Noppawan Piaseu, Nipa Rojroongwasinkul, Kalyana Sundram, Donka Baykova, Parvin Abedi, Sandjaja Sandjaja, Fariza Fadzil, Noriklil Bukhary Ismail Bukhary, Pascal Bovet, Yu Chen, Norie Sawada, Shoichiro Tsugane, Lalka Rangelova, Stefka Petrova, Vesselka Duleva, Anna Karin Lindroos, Jessica Petrelius Sipinen, Lotta Moraeus, Per Bergman, Ward Siamusantu, Lucjan Szponar, Hsing-Yi Chang, Makiko Sekiyama, Khanh Le Nguyen Bao, Balakrishna Nagalla, Kalpagam Polasa, Sesikeran Boindala, Jalila El Ati, Ivonne Ramirez Silva, Juan Rivera Dommarco, Simon Barquera, Sonia Rodríguez-Ramírez, Daniel Illescas-Zarate, Luz Maria Sanchez-Romero, Nayu Ikeda, Sahar Zaghloul, Anahita Houshiar-rad, Fatemeh Mohammadi-Nasrabadi, Morteza Abdollahi, Khun-Aik Chuah, Zaleha Abdullah Mahdy, Alison Eldridge, Eric L. Ding, Herculina Kruger, Sigrun Henjum, Anne Fernandez, Milton Fabian Suarez-Ortegon, Nawal Al-Hamad, Veronika Janská, Reema Tayyem, Parvin Mirmiran, Roya Kelishadi, Eva Warensjo Lemming, Almut Richter, Gert Mensink, Lothar Wieler, Daniel Hoffman, Benoit Salanave, Cho-il Kim, Rebecca Kuriyan-Raj, Sumathi Swaminathan, Didier Garriguet, Saeed Dastgiri, Sirje Vaask, Tilakavati Karupaiah, Fatemeh Vida Zohoori, Alireza Esteghamati, Maryam Hashemian, Sina Noshad, Elizabeth Mwaniki, Elizabeth Yakes-Jimenez, Justin Chileshe, Sydney Mwanza, Lydia Lera Marques, Alan Martin Preston, Samuel Duran Aguero, Mariana Oleas, Luz Posada, Angelica Ochoa, Khadijah Shamsuddin, Zalilah Mohd Shariff, Hamid Jan Bin Jan Mohamed, Wan Manan, Anca Nicolau, Cornelia Tudorie, Bee Koon Poh, Pamela Abbott, Mohammadreza Pakseresht, Sangita Sharma, Tor Strand, Ute Alexy, Ute Nöthlings, Jan Carmikle, Ken Brown, Jeremy Koster, Indu Waidyatilaka, Pulani Lanerolle, Ranil Jayawardena, Julie M. Long, K. Michael Hambidge, Nancy F. Krebs, Aminul Haque, Gudrun B. Keding, Liisa Korkalo, Maijaliisa Erkkola, Riitta Freese, Laila Eleraky, Wolfgang Stuetz, Inga Thorsdottir, Ingibjorg Gunnarsdottir, Lluis Serra-Majem, Foong Ming Moy, Simon Anderson, Rajesh Jeewon, Corina Aurelia Zugravu, Linda Adair, Shu Wen Ng, Sheila Skeaff, Dirce Marchioni, Regina Fisberg, Carol Henry, Getahun Ersino, Gordon Zello, Alexa Meyer, Ibrahim Elmadfa, Claudette Mitchell, David Balfour, Johanna M. Geleijnse, Mark Manary, Tatyana El-kour, Laetitia Nikiema, Masoud Mirzaei, Rubina Hakeem
Journal: Nature Medicine (2023)

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8-14.4 million) incident T2D cases, representing 70.3% (68.8-71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0-27.1%)), excess refined rice and wheat intake (24.6% (22.3-27.2%)) and excess processed meat intake (20.3% (18.3-23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4-87.7%)) and Latin America and the Caribbean (81.8% (80.1-83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1-60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.